Relationships In Recovery and the Dreaded 13th Step

Definition of the 13th Step: Using a recovery program to “hook-up” with someone with the intent of pursuing a romantic or sexual relationship, the act of having sex with another member of a 12-step fellowship. May be thought of as predatory behavior if the aggressor is trying to date a newcomer. The concern is that people in early recovery need to focus on sobriety. With this said, there have been many healthy relationships with people sharing long-term sobriety that have met in recovery. The one constant I’ve witnessed with these happy couples sharing recovery is their awareness that their individual sobriety always comes first.

Relationships in treatment and early recovery…

With single patients, the topics of romantic relationships and sexual encounters come up often. Married patients or patients in committed relationships have different types of relationship issues. Some are coming from unhealthy or abusive relationships that they plan to return to upon completing treatment. Patients with relatively healthy mates may have a good support system in place, however they have to work on mending the wreckage of their past.

How it works, as usual I start with the brain…

Younger patients many times divert attention from their programs by flirting or instigating sexual conversions with other patients. I see the excitement on their faces as they start connecting. Their body language indicates that are they are literally preparing for action. This physical attraction fires up pheromones, which in turn releases dopamine from the brain’s ventral tegmental area (VTA). Ironically the VTA, the first area of the brain triggered by addictive chemicals, is also the area first triggered by romance. Three areas of the mid-brain that have to do with relationships…

1) The hypothalamus (in the front part of the midbrain) sends signals to release testosterone and creates “the urge to have sex” (absolutely – nothing to do with real love).

2) The VTA (an area in the lower midbrain) releases dopamine the pleasure neurotransmitter and hormone. The VTA allows for that warm, wonderful romantic feeling of love you experience in a new relationship. The excitement created by the mere presence of that special person usually wears off over time (six months to a year). The body builds up a tolerance and stops releasing the feel good chemicals.

3) The (an area in the upper midbrain) is associated with long term, great companion, not sexually driven relationships. The attraction to one another is present even when the euphoria of sexual arousal is not. Obviously it far more complicated, nevertheless I hope you get the idea that different areas of the midbrain are associated with different types and levels of personal relationships.

Back to the patients…

Patients start to physically and emotionally wake up as the toxins are being eliminated from their bodies. Although they may still feel the pain and stress from withdrawal, they are starting to feel alive for the first time in years.

Patients naturally bond in treatment facilities and sharing, giving and receiving feedback is essential in the recovery process. Many patients become very close with peers because they finally have someone who relates to them without being judgmental.

This bonding occasionally results in a “Rehab Romance.” It may start as “just friends” but over time they may become convinced they have found the new love of their life, the hypothalamus – VTA type of love. Of course, the problem here is that it consumes the patient’s time, energy and focus thus losing the benefits of why they came to treatment.

When confronted, the patient will usually deny this is taking place. This is the brains defense mechanism speaking for them, as the brain wants to replace the “highs” from drugs and alcohol with sexual gratification. Addicts and alcoholics are not patient people. We are used to getting results quickly. The upshot of ingesting alcohol and drugs is instant gratification, so it stands to reason that we want instant gratification in other areas of our lives, including sex, love and being needed.

What’s a counselor to do?

If you’ve read my previous articles, I often mention changing one’s belief system. That applies here also. Recently in a group, a young person stated, “I love sex and I want it now!” That was the same belief system that tells us “I love drugs and I want some now” the belief is “If I want it I must have it”.

Dr. Drew Pinsky states, an addicts/alcoholics brain tells them, “if they don’t use they are committing suicide.” That belief system is the result of having a hi-jacked brain, a brain that does not recognize reality. Intellectually, people many times recognize what they are doing is wrong, however when the craving or urge kicks in all reasoning falls out the window. The focus turns to: “I want, I need, and therefore I must act.” This type of thought process also applies to other compulsive behaviors and addictions such as; anorexia, binging, purging, cutting and gambling, shopping, sex, love.

In recovery, we try to enlighten people that they actually have a choice. The choice is, “no matter how strong the urge, the craving or the desire if you can just not act right now, in this moment, and just get through the next minute, hour, day you will be OK.

It is imperative that a recovering person is aware that cravings are not continuous, most cravings last only a short time. An addict’s or alcoholics obsessive thinking is the problem. I suggest that when you get a craving to instantly ask yourself: “If I choose to act on my compulsion, what will happen next? And then what? And then what?”

Process the “then whats” to the arrest, the accident, the hangover, the hurt family, all the way through to your death. The craving will pass, then redirect your awareness to self-enhancing thoughts such as listing five things you are grateful for, or what is good in your life.

Rise above your humanness…

WE ARE NOT SOLELY PHYSICAL BEINGS – We are mental, emotional and spiritual beings as well. If a person honestly recognizes that changing a belief system takes monumental focus “on being” opposed to “on doing” they can resist the temptation to act on “I want”.

In Summary…

If you are in a supportive, committed relationship – stay there.

If you are not in a relationship – stay there.

In you are in an unhealthy/abusive relationship – get help, the situation will not get better on its own.

Until we are strong enough to put recovery first and keep it first no matter what, we are not ready to navigate a new relationship.

Recovery is a joyous but slow process – nothing about it happens instantly. Receive the gift of a year fully engaged in your recovery. This includes step-work, therapy, healing, growth,
and attention to nutrition, rest, exercise and health.